Dr Nowakowski on the EPCORE NHL-1 Trial Results of Epcoritamab in R/R Follicular Lymphoma

Grzegorz S. Nowakowski, MD, consultant, Division of Hematology; enterprise deputy director, Clinical Research, Mayo Clinic Comprehensive Cancer Center, discusses the results from the phase 1/2 EPCORE NHL-1 trial (NCT03625037), which evaluated epcoritamab-bysp (Epkinly) as a third-line treatment option in patients with relapsed/refractory follicular lymphoma (FL).

Notably, findings from this investigation supported the June 2024 FDA approval of epcoritamab for adult patients with relapsed or refractory FL following 2 or more lines of systemic therapy. Epcoritamab is a bispecific antibody that has had promising activity in various B-cell lymphomas, including aggressive types, Nowakowski begins. Given the unmet need for effective therapies for relapsed and refractory FL, the rationale for the trial was to evaluate the efficacy of epcoritamab in this patient population, he shares, adding that preliminary data from both phase 1 studies and preclinical research indicated that this treatment could be highly effective for these patients.

The study focused on patients who had relapsed after first- or second-line therapies, many of whom were double-refractory to both rituximab (Rituxan) and alkylating agents, both of which are standard treatments in this context, Nowakowski continues. Despite this challenging-to-treat patient population, the overall response rate to epcoritamab was 82% (95% CI, 74.1%-88.2%), indicating a meaningful resolution of lymphoma as evidenced by imaging studies, he explains. This high level of efficacy highlights the potential of epcoritamab as a significant advancement in treating patients with relapsed and refractory FL, Nowakowski says.

An important consideration with such effective therapies is the durability of the response, he expands. Follow-up data from this study revealed that the median duration of response had not yet been reached (NR; 95% CI, 13.7-NR) after an estimated median follow-up of 14.8 months, Nowakowski states, adding that many of the patients continued to respond to treatment at the 12-month mark. These results indicate that epcoritamab is highly effective with benefits that are long-lasting and sustainable in this patient population, he notes. This durability adds further excitement about the potential of epcoritamab as a breakthrough therapy for relapsed and refractory FL, Nowakowski concludes.